Spitting image: can saliva biomarkers reflect Alzheimer's disease?

Spitting image: can saliva biomarkers reflect Alzheimer's disease?
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吐痰图片:唾液生物标记物能反映阿尔茨海默病吗?

DOI:
10.1016/j.ebiom.2021.103437
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发表时间:
2021-06
期刊:
影响因子:
11.1
通讯作者:
Zetterberg H
Zetterberg H
中科院分区:
医学1区
文献类型:
--
作者:
Ashton NJ;Blennow K;Zetterberg H

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长期以来,人们一直在寻求一种易于获得的非侵入性生物流体测试来表征阿尔茨海默病(AD)的病理标志,淀粉样蛋白b和tau。这些测试可以帮助认知能力下降的鉴别诊断,并在AD的长期症状前阶段,突出那些可能从治疗干预中获益最多的人。在这方面,淀粉样蛋白b(Ab 42/40)、总tau(t-tau)和磷酸化tau(p-tau)的脑脊液(CSF)已经领先,并且现在被纳入AD的诊断标准。然而,由于其据称的侵入性或其所需的专业性,人们不太愿意通过腰椎穿刺收集CSF。在这种背景下,新近开发的检测淀粉样蛋白b和p-tau的血液检测方法[1](已被证明对AD病理学具有高度特异性)和神经丝光(NfL)[2](轴突损伤的一般生物标志物)已成为中心阶段,并具有在临床医学中广泛应用的巨大潜力。那么,问题仍然是,我们能比血液更进一步吗?其他生物流体也是一种选择吗?虽然血液生物标志物比CSF或正电子发射断层扫描(PET)更容易在临床实践中实施,但它们仍然存在较小的后勤挑战,例如静脉穿刺收集或受控的预分析。生物资源,如唾液,可以提供一个更简单的替代方案,这可能会受到患者或研究参与者的青睐。人们甚至可以设想一个家庭收集唾液的协议,用于研究研究,潜在的药物试验招募,或者在最近的2020 - 2021年流行病事件中,在不允许探视的情况下进行临床监测。
An easily accessible and non-invasive biofluid test to characterize the pathological hallmarks of Alzheimer’s disease (AD), amyloidÀb and tau, has been long sought after. Such tests could assist in the differential diagnosis of cognitive decline and, in the long pre-symptomatic phase of AD, highlight those who might benefit the most from therapeutic intervention. Cerebrospinal fluid (CSF) for amyloidÀb (Ab42/40), total tau (t-tau) and phosphorylated tau (p-tau) have led the way in this regard, and are now incorporated into diagnostic criteria for AD. Yet, there is some reluctance towards CSF collection via lumbar puncture due to its alleged invasiveness or the specialism that it requires. In this context, the newly developed blood tests for the detection of amyloidÀb and p-tau [1], which have been shown to be highly specific to AD pathology, and neurofilament light (NfL)[2], which is general biomarker for axonal injury, have taken center stage and have enormous potential for extensive application in clinical medicine.Then, the question remains, can we go further than blood? Are other biofluids also an option? Although blood biomarkers are easier than CSF or position emission tomography (PET) to implement in clinical practice, they still have minor logistical challenges eg, venipuncture collection or controlled pre-analytics. A bio resource such as saliva may offer an even more simplistic alternative, which may be favored by patients or study participants. One could even envisage a home collection protocol for saliva for research studies, potential recruitment into drug trials or, in the recent epidemic events of 2020À2021, clinical monitoring when visitation is not permitted.
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发表时间: 2017
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影响因子: 11.1
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